Document Detail

Diabetes Interactive Diary: a new telemedicine system enabling flexible diet and insulin therapy while improving quality of life: an open-label, international, multicenter, randomized study.
MedLine Citation:
PMID:  19808926     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Widespread use of carbohydrate counting is limited by its complex education. In this study we compared a Diabetes Interactive Diary (DID) with standard carbohydrate counting in terms of metabolic and weight control, time required for education, quality of life, and treatment satisfaction.
RESEARCH DESIGN AND METHODS: Adults with type 1 diabetes were randomly assigned to DID (group A, n = 67) or standard education (group B, n = 63) and followed for 6 months. A subgroup also completed the SF-36 Health Survey (SF-36) and World Health Organization-Diabetes Treatment Satisfaction Questionnaire (WHO-DTSQ) at each visit.
RESULTS: Of 130 patients (aged 35.7 +/- 9.4 years; diabetes duration 16.5 +/- 10.5 years), 11 dropped out. Time for education was 6 h (range 2-15 h) in group A and 12 h (2.5-25 h) in group B (P = 0.07). A1C reduction was similar in both groups (group A from 8.2 +/- 0.8 to 7.8 +/- 0.8% and group B from 8.4 +/- 0.7 to 7.9 +/- 1.1%; P = 0.68). Nonsignificant differences in favor of group A were documented for fasting blood glucose and body weight. No severe hypoglycemic episode occurred. WHO-DTSQ scores increased significantly more in group A (from 26.7 +/- 4.4 to 30.3 +/- 4.5) than in group B (from 27.5 +/- 4.8 to 28.6 +/- 5.1) (P = 0.04). Role Physical, General Health, Vitality, and Role Emotional SF-36 scores improved significantly more in group A than in group B.
CONCLUSIONS: DID is at least as effective as traditional carbohydrate counting education, allowing dietary freedom for a larger proportion of type 1 diabetic patients. DID is safe, requires less time for education, and is associated with lower weight gain. DID significantly improved treatment satisfaction and several quality-of-life dimensions.
Maria C E Rossi; Antonio Nicolucci; Paolo Di Bartolo; Daniela Bruttomesso; Angela Girelli; Francisco J Ampudia; David Kerr; Antonio Ceriello; Carmen De La Questa Mayor; Fabio Pellegrini; David Horwitz; Giacomo Vespasiani
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-10-06
Journal Detail:
Title:  Diabetes care     Volume:  33     ISSN:  1935-5548     ISO Abbreviation:  Diabetes Care     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-30     Completed Date:  2010-03-19     Revised Date:  2011-07-19    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109-15     Citation Subset:  IM    
Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro (CH), Italy.
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MeSH Terms
Diabetes Mellitus, Type 1 / diet therapy*,  drug therapy*
Hypoglycemic Agents / therapeutic use*
Insulin / therapeutic use*
Middle Aged
Quality of Life
Treatment Outcome
Reg. No./Substance:
0/Hypoglycemic Agents; 11061-68-0/Insulin

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